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Epidemic Intelligence A new paradigm for surveillance Denis Coulombier ECDC.

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Presentation on theme: "Epidemic Intelligence A new paradigm for surveillance Denis Coulombier ECDC."— Presentation transcript:

1 Epidemic Intelligence A new paradigm for surveillance Denis Coulombier ECDC

2 Epidemic Intelligence Model

3 Epidemic Intelligence Framework ReportData Capture Filter Verify Collect Analyse Interpret Assess Investigate Signal EWRS MS DSNs EWGLI Enternet EISS… BSN EMEA, EFSA MedISys GPHIN WHO-OVL Promed OIE FAO … Event-based surveillance DSNs BSN Laboratory network Indicator-based surveillance Control measures Public health alert EWRS MS Commission Other heath related EU agencies WHO-IHR? Disseminate

4 Epidemic Intelligence Definition « Epidemic intelligence is the process to detect, verify, analyze, assess and investigate signals that may represent a threat to public health. It encompasses all activities related to early warning functions but also signal assessments and outbreak investigation. »

5 Epidemic Intelligence Input –MS, EWRS, DSNs (EWGLI, Enternet, EISS…), BSN –MedISys, GPHIN, WHO outbreak verification list, Promed –Verification, analysis Assessment, investigation, response –In liaison with MS and Commission –With a European added-value perspective Output –Daily verification list (internal) –Weekly summary (EWRS, epidemiologists, policy-makers) –EuroSurveillance weekly? –Yearly report

6 Epidemic intelligence Event detection



9 Event verification The systematic process by which ECDC verifies the reality of events, their aetiology, potential for spread and the need for assistance in affected member states Focuses on events of European Public Health Concern

10 Event verification No Is the event relevant? Yes Immediate verification required? Status Decision Process Irrelevant event Event No Verification within 24 hours Event not verified Yes Verification Signal

11 The WHO Experience Recorded and Verified Events by Year 95 (58) 104 (71) 161 (68) 129 (65) 46 (68) 535 (66) Median days to verification = 2 Range 0 to 109 days YearEvents recordedEvents verified (%) *68 Total812 * Up to March 31, 2002

12 Signal assessment No Yes No Yes No Yes Signal Alert of National scope requiring European information Alert of National scope Alert of national scope requiring European support Alert of European scope Requiring European coordination Significant public health impact? Insufficient national capacity for response? Risk of European spread? Need for European information? Status Decision Alert not confirmed

13 Criteria for Signal Assessment Unknown illness High mortality or morbidity European disease spread Interference with travel or trade Need for European assistance Suspected accidental or deliberate release of biologic or chemical agents

14 Standard operating procedures Daily Coordinating Meeting Review incoming reports of events Monitor the verification process Determine which events should be included in the weekly bulletin Determine which events should be posted on the Early Warning and Response System Assess the need for ECDC-facilitated assistance Initiate a response to the assessed need for ECDC-facilitated assistance Monitor ECDC-facilitated assistance


16 Event verification list, Olympic Games EWAR system, Athens, Greece, August 2004

17 Feedback at European Level ECDC threat assessment weekly bulletin European commission commisionner briefing Early Warning and Response System Eurosurveillance ECDC website




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